Increased Social Withdrawal And Isolation In The Context Of Intact Hedonic Capacity In People At Ultra-High Risk For Psychosis: An Experience Sampling Study.

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Presentation First Author:

Tineke Lataster

Abstract:

Background: Results from recent studies suggest that negative symptoms predict transition to psychotic disorder in individuals with an at risk mental state. Aim of the current study was to investigate how negative symptoms are displayed in the daily life of people at ultra-high risk (UHR). Method: Twenty-seven individuals at UHR, 27 schizophrenia patients, and 27 healthy controls were assessed using the Experience Sampling Method (a structured diary technique). This technique allows for the individual to give a moment-to-moment evaluation of the context. Results: UHR-individuals showed higher levels of social withdrawal compared to controls, whereas patients did not differ from the control group. UHR-individuals were alone more often (57% of the time) relative to patients (42%) and controls (33%). Schizophrenia patients showed higher levels of negative emotions when alone, whereas UHR-individuals did not. UHR-individuals and schizophrenia patients had overall lower levels of positive emotions compared to healthy controls. The UHR-group also reported significantly less positive events compared to controls, and this was not the case for patients. No evidence was found for (social) anhedonia in any of the three groups. Discussion: The results suggest that negative symptoms are highly prevalent in the prodromal phase of psychotic disorder. In addition, no evidence is found for a reduced capacity to experience pleasure in individuals at UHR or in schizophrenia patients relative to healthy controls. This is in accordance with ample evidence that anticipation of pleasure (“wanting”) rather than consuming it (“liking”) is affected in schizophrenia.